Treatment of Periprosthetic Joint Infection Using Antimicrobials: Dilute Povidone-Iodine Lavage

Journal of Bone and Joint Infection
John A Ruder, Bryan D Springer

Abstract

Periprosthetic joint infections (PJI) remain a challenge for the orthopaedic surgeon to treat and remain a leading cause of failure of both primary and revision total joint arthroplasty. Once a PJI develops, surgical treatment is generally indicated and includes an aggressive irrigation and debridement. One component of the irrigation and debridement involves the use of an antiseptic irrigating solution. In primary and revision TJA, dilute povidone-iodine lavage can be performed prior to wound closure. Approximately 17.5mL of 10% povidone-iodine is diluted with 500-1000cc of normal saline. The wound is then irrigated with the dilute povidone-iodine for 3 minutes. The dilute povidone-iodine is then thoroughly irrigated and washed out of the wound with normal saline prior to wound closure. The use of dilute povidone-iodine lavage prior to wound closure has been shown to reduce the risk of deep surgical site infection in multiple surgical specialties. In primary TJA, it has been demonstrated to reduce the risk of infection, without any associated adverse effects. It is also included in multiple protocols for the surgical treatment of PJI. Dilute povidone-iodine lavage provides a safe and inexpensive method to reduce the rate of PJ...Continue Reading

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Citations

Jun 22, 2018·Current Reviews in Musculoskeletal Medicine·Mariam TahaAlberto V Carli
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Jun 11, 2021·Journal of Bone and Joint Infection·Ahmed SiddiqiAntonia F Chen
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Oct 3, 2021·The Journal of Knee Surgery·Blair S Ashley, Javad Parvizi
Nov 9, 2021·Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews·Stuart IrwinSimon Swift

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Methods Mentioned

BETA
total hip arthroplasties
lavage
lavaging

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